The long-term objective of this proposal is to create a Center for Improving Patient Safety located in Nashville, TN as a collaboration among four institutions: Vanderbilt University, Meharry Medical College, the VA Tennessee Valley Healthcare System and the National Patient Safety Foundation. Project goals are: (1) to use and modify existing safety and medical error reporting systems and develop new systems to study the typology and epidemiology of errors, (2) to examine differences is these systems between populations and delivery systems that differ in patient race, ethnicity and socioeconomic status, (3) to develop systems for improving patient safety, (4) to examine the organization and cultural issues that facilitate or impede error reporting and safety improvement, (5) to develop educational programs that will reduce errors and improve safety, (6) and to design, implement, analyze and disseminate the results from a pilot project addressing the epidemiology of medical errors with a focus on a minority population, (7) host a site visit from AHRQ to review the host year's work and assist in the design of the pilot project, (8) in Phase II of the project (years 2 and 3), implement the pilot project, (9) analyze the pilot project data, interpret the results and develop a report of the findings, (10) develop further projects and seek to become a center of excellence in patient safety research and education. The project builds on long-standing relationships between Vanderbilt University, the VA Tennessee Valley Healthcare System and Meharry Medical College and takes advantage of their collaborations in the Center for Health Services Research, Center for Clinical Improvement, Institute for Community Health, the national Quality Scholars Program, the Geriatric Research, Education and Clinical Center and introduces an important new collaboration with the National Patient Safety Foundation.